Key result
Elevated false lumen OSI and reduced true lumen pressure post-TEVAR are linked to subsequent aortic dilatation.
Why the study?
The hemodynamic factors associated with aortic dilatation following thoracic endovascular aortic repair for type-B aortic dissection were not well understood.
Are specific hemodynamic factors, such as oscillatory shear index and true lumen pressure, associated with aortic dilatation following TEVAR for type-B aortic dissection?
Case-Control (n=57)
No
Are specific hemodynamic factors, such as oscillatory shear index and true lumen pressure, associated with aortic dilatation following TEVAR for type-B aortic dissection?
p-value: p=<0.05
Elevated oscillatory shear index in the false lumen and reduced true lumen pressure early post-TEVAR are associated with subsequent aortic dilatation in patients with type-B aortic dissection.
High OSI in false lumen may predict post-TEVAR aortic dilatation; hypothesis-generating, needs prospective trials before clinical adoption.
Objective We aimed to investigate the hemodynamic factors associated with aortic dilatation following thoracic endovascular aortic repair (TEVAR) for type-B aortic dissection (TBAD). Methods This retrospective study enrolled patients who developed aortic dilatation following TEVAR for TBAD, patients who did not develop aortic dilatation following TEVAR for TBAD, and healthy control subjects. Computed tomography angiography (CTA) images for the dilatation group were acquired at three time points: pre-TEVAR (Group A), 1-week post-TEVAR (Group B), and the most recent follow-up (Group C). For the non-dilatation group, CTA images were acquired pre-TEVAR (Group D) and 1 week post-TEVAR (Group E). The control group underwent a single CTA examination (Group F). Three-dimensional (3D) models were reconstructed from CTA images, and computational fluid dynamics (CFD) simulations were performed. The oscillatory shear index (OSI) at the ostia of the major arterial branches was defined as the primary CFD endpoint. Results In the dilatation group, the pressures at the ostia of the brachiocephalic trunk, left common carotid artery, left subclavian artery, celiac trunk, superior mesenteric artery, bilateral renal arteries, inferior mesenteric artery, and bilateral common iliac arteries were lower in Group B than in Groups A and C. In the non-dilatation group, the pressures at the ostia of the brachiocephalic trunk, left common carotid artery, left subclavian artery, celiac trunk, superior mesenteric artery, left renal artery, inferior mesenteric artery, and right common iliac artery were higher in Group E than in Group D. The false lumen in Group B exhibited a larger region of high OSI compared with that in Group E. Conclusion Elevated OSI in the false lumen is associated with a greater tendency toward aortic dilatation following TEVAR for TBAD. Patients with reduced true lumen pressure in the early post-TEVAR period show a corresponding trend toward subsequent aortic dilatation.
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Tang et al. (2026) conducted a case-control in Type-B aortic dissection (TBAD) (n=57). Thoracic endovascular aortic repair (TEVAR) vs. Patients without aortic dilatation after TEVAR and healthy controls was evaluated on Oscillatory shear index (OSI) at the ostia of the major arterial branches (p=<0.05). Elevated oscillatory shear index in the false lumen and reduced true lumen pressure in the early post-TEVAR period are associated with subsequent aortic dilatation in patients with type-B aortic dissection.
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